PT  - JOURNAL ARTICLE
AU  - Maroun J. Mhanna
AU  - Ingrid M. Anderson
AU  - Narayan P. Iyer
AU  - Amy Baumann
TI  - The use of Extubation Readiness Parameters: A Survey of Pediatric Critical Care Physicians
AID  - 10.4187/respcare.02469
DP  - 2013 Aug 13
TA  - Respiratory Care
PG  - respcare.02469
4099  - http://rc.rcjournal.com/content/early/2013/08/13/respcare.02469.short
4100  - http://rc.rcjournal.com/content/early/2013/08/13/respcare.02469.full
AB  - Background: The pediatric literature addressing extubation readiness parameters and strategies to wean from mechanical ventilation is limited in children. Methods: A survey was designed to assess the implementation of extubation readiness parameters among Pediatric Critical Care Physicians who are affiliated to academic centers in the United States. Results: The overall response rate to the survey was 44.1% (417/945). The majority of responders check for an air leak, and check for the amount of tracheal secretions; and fewer physicians use sedation scores, perform a Rapid Shallow Breath Index (RSBI), and measure an airway occlusion pressure at 0.1 sec (P0.1 sec) prior to extubation. The majority perform a SBT with pressure support (PS). The majority consider 30 cm of H2O as the upper limit of an air leak test, and the need for endotracheal suctioning once every 2-4 hours as acceptable for extubation. In preparation for termination of mechanical ventilation the majority wean daily ventilator rates and or PS instead of daily SBT. Conclusions: Most PCCP report assessing extubation readiness by checking for air leak and suctioning needs, and less often consider or perform sedation scores or RSBI. Future studies on the best extubation parameters in children are needed.